| NPI | 1649867151 |
|---|---|
| Other Name | MANDI JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2020-12-30 |
| Last Update Date | 2021-09-02 |